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Keshavarz F, Zeinalabedini M, Ebrahimpour-Koujan S, Azadbakht L. A systematic review and meta-analysis of the association of all types of beverages high in fructose with asthma in children and adolescents. BMC Nutr 2024; 10:123. [PMID: 39294754 PMCID: PMC11409540 DOI: 10.1186/s40795-024-00930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 09/05/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Asthma has become the most common chronic condition among children in recent decades. Environmental factors, including food, drive its rise. Sweetened beverages are a staple of children's diets and cause various health issues. Therefore, this research aims to evaluate the association of all types of high fructose beverages with asthma in children. METHOD We assessed observational studies published before November 2023, obtained from PubMed, Scopus, and Web of Science. The quality of articles was assessed by using the Newcastle-Ottawa Scale. Studies with a pediatric population under 18 years that indicate the association between all kinds of beverages containing high fructose and asthma and evaluated risk estimates with 95% confidence intervals were included. We also followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). RESULTS In the final analysis, we included eleven studies with 164,118 individuals. Twenty-one effect sizes indicated a significant positive association between sugar-sweetened beverages (SSBs) consumption and odds of asthma (OR: 1.28; 95% CI: 1.15-1.42; Pvalue < 0.001). Three effect sizes showed that total excess free fructose (tEFF) intake increases children's asthma odds by 2.7 times (pooled OR: 2.73; 95% CI: 1.30-5.73; Pvalue =0.008). However, five effect sizes in 100% fruit juice failed to show statically association with asthma prevalence in children (pooled OR: 1.43; 95%CI: 0.91-2.23; Pvalue =0.12). CONCLUSION In summary, SSB and tEFF raised asthma probabilities. No relationship was found between fruit juice and asthma in children and adolescents. We need more cohort studies with correct age selection to identify the precise link.
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Affiliation(s)
- Fatemeh Keshavarz
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 1416643931, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mobina Zeinalabedini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 1416643931, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soraiya Ebrahimpour-Koujan
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 1416643931, Tehran, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran.
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Huang S, He Q, Wang X, Choi S, Gong H. Associations of the planetary health diet index (PHDI) with asthma: the mediating role of body mass index. BMC Public Health 2024; 24:2305. [PMID: 39187832 PMCID: PMC11346270 DOI: 10.1186/s12889-024-19856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 08/22/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Given the global shifts in environmental conditions and dietary habits, understanding the potential impact of dietary factors and body mass index (BMI) on respiratory diseases, including asthma, is paramount. Investigating these relationships can contribute to the formulation of more effective prevention strategies. The Planetary Health Diet Index (PHDI), a dietary scoring system that balances human health with environmental sustainability, underscores the importance of increasing the consumption of plant-based foods while reducing the intake of red meat, sugar, and highly processed foods. The objective of this study was to assess the association between PHDI and the prevalence of asthma and the mediation effect of BMI in a US general population. METHODS This study utilized data from 32,388 participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between PHDI, individual nutrients, and asthma. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between PHDI and asthma. Interaction analyses were conducted on subgroups to validate the findings. Mediation analysis was performed to examine the effect of BMI on the relationship between PHDI and asthma. RESULTS There was a significant negative association between PHDI and asthma. After adjusting for covariates, for every 10-point increase in PHDI, there was a 4% decrease in the prevalence of asthma (P = 0.025). Moreover, as PHDI increased, there was a trend towards lower asthma prevalence (P for trend < 0.05). WQS analyses showed consistent associations (OR = 0.93, 95%CI: 0.88, 0.98), with Fiber, Vitamin C, and Protein significant factors. The dose-response curve indicated a linear association between PHDI and asthma, with higher PHDI associated with lower asthma prevalence. Additionally, BMI is significantly positively associated with asthma (P < 0.001), and BMI decreases as the PHDI increases (β = -0.64, P < 0.001). Mediation analysis indicates that BMI significantly mediates the relationship between PHDI and asthma, with a mediation proportion of 33.85% (P < 0.001). CONCLUSION The results of this study show a strong negative correlation between PHDI and the prevalence of asthma. In addition, BMI mediated this negative relationship.
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Affiliation(s)
- Shaoqun Huang
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou City, Fujian Province, China
| | - Qiao He
- Graduate School of Tianjin, University of Traditional Chinese Medicine, Tianjin City, China
| | - Xiaoxuan Wang
- Graduate School of Tianjin, University of Traditional Chinese Medicine, Tianjin City, China
| | - Seok Choi
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Korea
| | - Hongyang Gong
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Korea.
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Paparo L, Coppola S, Nocerino R, Pisapia L, Picariello G, Cortese M, Voto L, Maglio M, Miele E, Carucci L, Oglio F, Trinchese G, Mollica MP, Bruno C, De Vita S, Tarallo A, Damiano C, Cerulo M, Esposito C, Fogliano V, Parenti G, Troncone R, Berni Canani R. How dietary advanced glycation end products could facilitate the occurrence of food allergy. J Allergy Clin Immunol 2024; 153:742-758. [PMID: 38042501 DOI: 10.1016/j.jaci.2023.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 11/02/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Food allergy (FA) is one of the most common chronic conditions in children with an increasing prevalence facilitated by the exposure to environmental factors in predisposed individuals. It has been hypothesized that the increased consumption of ultra-processed foods, containing high levels of dietary advanced glycation end products (AGEs), could facilitate the occurrence of FA. OBJECTIVE We sought to provide preclinical and clinical evidence on the potential role of AGEs in facilitating the occurrence of FA. METHODS Human enterocytes, human small intestine organ culture, and PBMCs from children at risk for allergy were used to investigate the direct effect of AGEs on gut barrier, inflammation, TH2 cytokine response, and mitochondrial function. Intake of the 3 most common glycation products in Western diet foods, Nε-(carboxymethyl) lysine, Nε-(1-carboxyethyl) lysin, and Nδ-(5-hydro-5- methyl-4-imidazolone-2-yl)-ornithine (MG-H1), and the accumulation of AGEs in the skin were comparatively investigated in children with FA and in age-matched healthy controls. RESULTS Human enterocytes exposed to AGEs showed alteration in gut barrier, AGE receptor expression, reactive oxygen species production, and autophagy, with increased transepithelial passage of food antigens. Small intestine organ cultures exposed to AGEs showed an increase of CD25+ cells and proliferating crypt enterocytes. PBMCs exposed to AGEs showed alteration in proliferation rate, AGE receptor activation, release of inflammatory and TH2 cytokines, and mitochondrial metabolism. Significant higher dietary AGE intake and skin accumulation were observed children with FA (n = 42) compared with age-matched healthy controls (n = 66). CONCLUSIONS These data, supporting a potential role for dietary AGEs in facilitating the occurrence of FA, suggest the importance of limiting exposure to AGEs children as a potential preventive strategy against this common condition.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Laura Pisapia
- Institute of Genetics and Biophysics, National Research Council, Naples, Italy
| | | | - Maddalena Cortese
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Mariantonia Maglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | | | | | - Cristina Bruno
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Simone De Vita
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Antonietta Tarallo
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Carla Damiano
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Mariapina Cerulo
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Ciro Esposito
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Vincenzo Fogliano
- Food Quality and Design Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Giancarlo Parenti
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Riccardo Troncone
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy; Task Force for Microbiome Studies, University Federico II, Naples, Italy; Task Force for Nutraceuticals and Functional Foods, University Federico II, Naples, Italy.
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Leduc L, Costa M, Leclère M. The Microbiota and Equine Asthma: An Integrative View of the Gut-Lung Axis. Animals (Basel) 2024; 14:253. [PMID: 38254421 PMCID: PMC10812655 DOI: 10.3390/ani14020253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Both microbe-microbe and host-microbe interactions can have effects beyond the local environment and influence immunological responses in remote organs such as the lungs. The crosstalk between the gut and the lungs, which is supported by complex connections and intricate pathways, is defined as the gut-lung axis. This review aimed to report on the potential role of the gut-lung gut-lung axis in the development and persistence of equine asthma. We summarized significant determinants in the development of asthma in horses and humans. The article discusses the gut-lung axis and proposes an integrative view of the relationship between gut microbiota and asthma. It also explores therapies for modulating the gut microbiota in horses with asthma. Improving our understanding of the horse gut-lung axis could lead to the development of techniques such as fecal microbiota transplants, probiotics, or prebiotics to manipulate the gut microbiota specifically for improving the management of asthma in horses.
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Affiliation(s)
- Laurence Leduc
- Clinical Sciences Department, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
| | - Marcio Costa
- Veterinary Department of Biomedical Sciences, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
| | - Mathilde Leclère
- Clinical Sciences Department, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
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Clemente-Suárez VJ, Mielgo-Ayuso J, Ramos-Campo DJ, Beltran-Velasco AI, Martínez-Guardado I, Navarro Jimenez E, Redondo-Flórez L, Yáñez-Sepúlveda R, Tornero-Aguilera JF. Basis of preventive and non-pharmacological interventions in asthma. Front Public Health 2023; 11:1172391. [PMID: 37920579 PMCID: PMC10619920 DOI: 10.3389/fpubh.2023.1172391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Asthma is one of the most common atopic disorders in all stages of life. Its etiology is likely due to a complex interaction between genetic, environmental, and lifestyle factors. Due to this, different non-pharmacological interventions can be implemented to reduce or alleviate the symptoms caused by this disease. Thus, the present narrative review aimed to analyze the preventive and non-pharmacological interventions such as physical exercise, physiotherapy, nutritional, ergonutritional, and psychological strategies in asthma treatment. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Asthma is an immune-mediated inflammatory condition characterized by increased responsiveness to bronchoconstrictor stimuli. Different factors have been shown to play an important role in the pathogenesis of asthma, however, the treatments used to reduce its incidence are more controversial. Physical activity is focused on the benefits that aerobic training can provide, while physiotherapy interventions recommend breathing exercises to improve the quality of life of patients. Nutritional interventions are targeted on implement diets that prioritize the consumption of fruits and vegetables and supplementation with antioxidants. Psychological interventions have been proposed as an essential non-pharmacological tool to reduce the emotional problems associated with asthma.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
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Lupu A, Jechel E, Mihai CM, Mitrofan EC, Fotea S, Starcea IM, Ioniuc I, Mocanu A, Ghica DC, Popp A, Munteanu D, Sasaran MO, Salaru DL, Lupu VV. The Footprint of Microbiome in Pediatric Asthma-A Complex Puzzle for a Balanced Development. Nutrients 2023; 15:3278. [PMID: 37513696 PMCID: PMC10384859 DOI: 10.3390/nu15143278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
Considered to be of greater complexity than the human genome itself, the microbiome, the structure of the body made up of trillions of bacteria, viruses, and fungi, has proven to play a crucial role in the context of the development of pathological processes in the body, starting from various infections, autoimmune diseases, atopies, and culminating in its involvement in the development of some forms of cancer, a diagnosis that is considered the most disabling for the patient from a psychological point of view. Therefore, being a cornerstone in the understanding and optimal treatment of a multitude of ailments, the body's microbiome has become an intensively studied subject in the scientific literature of the last decade. This review aims to bring the microbiome-asthma correlation up to date by classifying asthmatic patterns, emphasizing the development patterns of the microbiome starting from the perinatal period and the impact of pulmonary dysbiosis on asthmatic symptoms in children. Likewise, the effects of intestinal dysbiosis reflected at the level of homeostasis of the internal environment through the intestine-lung/vital organs axis, the circumstances in which it occurs, but also the main methods of studying bacterial variability used for diagnostic purposes and in research should not be omitted. In conclusion, we draw current and future therapeutic lines worthy of consideration both in obtaining and maintaining remission, as well as in delaying the development of primary acute episodes and preventing future relapses.
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Affiliation(s)
- Ancuta Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Jechel
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | | | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800008 Galati, Romania
| | - Iuliana Magdalena Starcea
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ileana Ioniuc
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Mocanu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dragos Catalin Ghica
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Popp
- Faculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dragos Munteanu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Maria Oana Sasaran
- Faculty of General Medicine, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Delia Lidia Salaru
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Vasile Valeriu Lupu
- Faculty of General Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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Serra HCOA, Rudakoff LCS, Muniz AKOA, Magalhães EIDS, Bragança MLBM, Silva AAMD, Vianna EDSO, Bettiol H, Barbieri MA. Association between the Consumption of Ultra-Processed Foods and Asthma in Adults from Ribeirão Preto, São Paulo, Brazil. Nutrients 2023; 15:3165. [PMID: 37513583 PMCID: PMC10386360 DOI: 10.3390/nu15143165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Ultra-processed Food (UPF) consumption can play a role in the pathogenesis and progression of asthma. The aim of this study was to evaluate the association between the consumption of UPF and asthma. METHODS This cross-sectional study included 1857 adults aged 23-25 years from the Ribeirão Preto-SP birth cohort (1978/1979). The exposure variable was the consumption of UPF (expressed as their percentage contribution to energy intake-% total caloric value [%TCV] and their percentage contribution to the amount of food ingested-%grams), which was assessed with a food frequency questionnaire. Asthma was the outcome and was defined based on a positive methacholine challenge test and the presence of wheezing, chest tightness, or shortness of breath over the last 12 months. Poisson regression with robust variance was used to estimate the association between these variables. Unadjusted analyses and analyses adjusted for sex, age, household income, smoking, and physical activity level were performed. RESULTS The prevalence of asthma in the sample was 13.2%. The mean total consumption of UPF was 37.9 ± 11.2% TCV (corresponding to 35.1 ± 15.1% grams). There was no association between the consumption of UPF and asthma in adults. CONCLUSION This study provides no evidence for an association between the consumption of UPF and asthma in young adults.
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Affiliation(s)
| | | | | | | | | | | | | | - Heloisa Bettiol
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Marco Antonio Barbieri
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
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Visser E, de Jong K, Pepels JJS, Kerstjens HAM, Ten Brinke A, van Zutphen T. Diet quality, food intake and incident adult-onset asthma: a Lifelines Cohort Study. Eur J Nutr 2023; 62:1635-1645. [PMID: 36739315 DOI: 10.1007/s00394-023-03091-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study. METHODS Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m2). RESULTS 477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group. CONCLUSION The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.
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Affiliation(s)
- Edith Visser
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Janneke J S Pepels
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Huib A M Kerstjens
- Department of Pulmonary Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Tim van Zutphen
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands
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Boldrini GG, Martín Molinero G, Pérez Chaca MV, Ciminari ME, Moyano F, Córdoba ME, Pennacchio G, Fanelli M, Álvarez SM, Gómez NN. Glycine max (soy) based diet improves antioxidant defenses and prevents cell death in cadmium intoxicated lungs. Biometals 2022; 35:229-244. [PMID: 35038064 DOI: 10.1007/s10534-022-00361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/04/2022] [Indexed: 11/02/2022]
Abstract
Cadmium (Cd) is a toxic metal and an important environmental contaminant. We analyzed its effects on oligoelements, oxidative stress, cell death, Hsp expression and the histoarchitecture of rat lung under different diets, using animal models of subchronic cadmium intoxication. We found that Cd lung content augmented in intoxicated groups: Zn, Mn and Se levels showed modifications among the different diets, while Cu showed no differences. Lipoperoxidation was higher in both intoxicated groups. Expression of Nrf-2 and SOD-2 increased only in SoCd. GPx levels showed a trend to increase in Cd groups. CAT activity was higher in intoxicated groups, and it was higher in Soy groups vs. Casein. LDH activity in BAL increased in CasCd and decreased in both soy-fed groups. BAX/Bcl-2 semiquantitative ratio showed similar results than LDH activity, confirmed by Caspase 3 immunofluorescence. The histological analysis revealed an infiltration process in CasCd lungs, with increased connective tissue, fused alveoli and capillary fragility. Histoarchitectural changes were less severe in soy groups. Hsp27 expression increased in both intoxicated groups, while Hsp70 only augmented in SoCd. This show that a soy-diet has a positive impact upon oxidative unbalance, cell death and morphological changes induced by Cd and it could be a good alternative strategy against Cd exposure.
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Affiliation(s)
- Gabriel Giezi Boldrini
- Laboratory of Nutrition and Environment, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina
- IMIBIO-SL CONICET, San Luis, Argentina
| | - Glenda Martín Molinero
- Laboratory of Nutrition and Environment, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina
- IMIBIO-SL CONICET, San Luis, Argentina
| | - María Verónica Pérez Chaca
- Laboratory of Morphophysiology, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina
| | - María Eugenia Ciminari
- Laboratory of Morphophysiology, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina
| | | | | | | | - Mariel Fanelli
- Laboratory of Oncology, IMBECU (CCT), CONICET, Mendoza, Argentina
| | - Silvina Mónica Álvarez
- Laboratory of Nutrition and Environment, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina.
- IMIBIO-SL CONICET, San Luis, Argentina.
| | - Nidia Noemí Gómez
- IMIBIO-SL CONICET, San Luis, Argentina.
- Laboratory of Morphophysiology, Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis, San Luis, Argentina.
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Prevalence of Asthma and Its Associating Environmental Factors among 6-12-Year-Old Schoolchildren in a Metropolitan Environment-A Cross-Sectional, Questionnaire-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413403. [PMID: 34949011 PMCID: PMC8709131 DOI: 10.3390/ijerph182413403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022]
Abstract
We aimed to evaluate the prevalence of asthma and its associating environmental factors within a 6–12-year-old population. A cross-sectional, questionnaire-based study was conducted in primary schools located in the capital of Hungary; 3836 eligible parent-reported questionnaires were evaluated. Besides the International Study of Asthma and Allergies in Childhood (ISAAC) phase three core questions for asthma, the survey also assessed various potential risk factors. We introduced the umbrella term cumulative asthma as the union of physician-diagnosed asthma and current wheezing to estimate the lifetime prevalence of asthma. Current wheezing and physician-diagnosed asthma showed a frequency of 9.5% and 6.3%, respectively. They contributed to a cumulative asthma prevalence of 12.6% among the sampled population, with a girl-boy percentage of 37.4% to 62.6%. Air-pollution and weedy areas were associated with greater risk for asthma, while a suburban residence showed lesser odds. Indoor smoking, visible mold, and keeping a dog were defined as risk factors for asthma, while the presence of plants in the bedroom and pet rodents were associated with lower odds ratios. The consumption of fast food, beverages containing additives and margarine were significantly higher in asthmatics, while we found frequent sport activity and cereal intake associated with lower odds ratios for asthma. In this urban environment, we identified an increased asthma prevalence compared to some previously published studies, but the cross-sectional design and the different methodology did not permit us to draw timeframe-dependent conclusions.
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Flom JD, Chiu YHM, Cowell W, Kannan S, Ganguri HB, Coull BA, Wright RJ, Carroll K. Maternal active asthma in pregnancy influences associations between polyunsaturated fatty acid intake and child asthma. Ann Allergy Asthma Immunol 2021; 127:553-561.e3. [PMID: 34157395 DOI: 10.1016/j.anai.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Studies evaluating effects of prenatal polyunsaturated fatty acid (PUFA) intake on childhood asthma reveal mixed results. Inconsistencies may result from not accounting for important modifying factors such as maternal asthma or child sex. OBJECTIVE To evaluate whether associations between prenatal PUFA intake and childhood asthma are modified by prenatal active maternal asthma or child sex in 412 mother-child dyads. METHODS Energy-adjusted prenatal dietary and supplement intakes of omega-3 (n-3) and omega-6 (n-6) PUFAs were estimated using the Block98 Food Frequency Questionnaire, administered during pregnancy. Mothers reported asthma in children followed prospectively to 4.0 plus or minus 1.7 years. Generalized additive models with smooth terms for PUFA (n-3, n-6, n-6/n-3 ratio) effects were used to investigate associations between PUFAs and child asthma, without prespecifying the form of these relationships, including effect modification by active maternal asthma or child sex. RESULTS Among mothers (40% Black, 31% Hispanic), 22% had active asthma in pregnancy; 17.5% of children developed asthma. Lower maternal n-3 PUFA intake was significantly associated with risk of childhood asthma (P = .03), in particular among children of mothers with active asthma and low n-3 PUFA intake (P = .01). This inverse association was more apparent in girls (P = .01) compared with boys (P = .30), regardless of maternal asthma status. For n-6 PUFA and the n-6/n-3 ratio, there was a lower risk of childhood asthma in the midrange of intake and increased risk at higher intake (n-6 PUFA P = .10, n-6/n-3 ratio P = .13). CONCLUSION Consideration of factors that modify effects of prenatal PUFA intake on childhood asthma has implications for designing intervention strategies tailored to impact those at greatest risk.
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Affiliation(s)
- Julie D Flom
- Division of Pediatric Allergy & Immunology, Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Srimathi Kannan
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Harish B Ganguri
- Department of Information Systems Security, University of Cumberlands, Williamsburg, Kentucky
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kecia Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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12
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Alwarith J, Kahleova H, Crosby L, Brooks A, Brandon L, Levin SM, Barnard ND. The role of nutrition in asthma prevention and treatment. Nutr Rev 2021; 78:928-938. [PMID: 32167552 PMCID: PMC7550896 DOI: 10.1093/nutrit/nuaa005] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Asthma is a chronic respiratory condition characterized by airway inflammation and hyperreactivity. Prevalence has continued to rise in recent decades as Western dietary patterns have become more pervasive. Evidence suggests that diets emphasizing the consumption of plant-based foods might protect against asthma development and improve asthma symptoms through their effects on systemic inflammation, oxidation, and microbial composition. Additionally, increased fruit and vegetable intake, reduced animal product consumption, and weight management might mediate cytokine release, free radical damage, and immune responses involved in the development and course of asthma. The specific aim of this review paper is to examine the current literature on the associations between dietary factors and asthma risk and control in children and adults. Clinical trials examining the mechanism(s) by which dietary factors influence asthma outcomes are necessary to identify the potential use of nutritional therapy in the prevention and management of asthma.
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Affiliation(s)
- Jihad Alwarith
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Lee Crosby
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Alexa Brooks
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | | | - Susan M Levin
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Neal D Barnard
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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13
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Urrutia-Pereira M, Chong-Neto H, Mocellin LP, Ellwood P, Garcia-Marcos L, Simon L, Rinelli P, Solé D. Prevalence of asthma symptoms and associated factors in adolescents and adults in southern Brazil: A Global Asthma Network Phase I study. World Allergy Organ J 2021; 14:100529. [PMID: 33850603 PMCID: PMC8010518 DOI: 10.1016/j.waojou.2021.100529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/02/2021] [Accepted: 02/14/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The Global Asthma Network (GAN) aims to find out the current status of the prevalence and severity of asthma, rhinitis, and eczema using global surveillance to achieve worldwide recognition and improve the management of asthma, especially in low- and middle-income countries. The aim of this study was to verify the associated factors for asthma in adolescents and their respective parents/caregivers. METHODS Adolescents (13-14 years old; n = 1058) and their respective parents/caregivers (mean age = 42.1 years, n = 896) living in the town of Uruguaiana, Southern Brazil fulfilled the standardized questionnaire. RESULTS Although the prevalence of wheezing in the past 12 months was higher among adults than adolescents (18.4% vs. 15.8%, respectively), adolescents showed more severe wheezing and worse control over the disease revealed by higher consumption of short-acting beta-2 agonists; going to the emergency room; hospitalization in the last year and dry night cough. Smoking and paracetamol use were associated with risk for developing asthma symptoms and consuming seafood/fish was protective. For the adults smoking (10 or more cigarettes/day) and exposure to mould in the house were associated with risk for asthma symptoms. CONCLUSIONS Adolescents have a high prevalence of asthma symptoms and few have an action plan. Adults do not have their disease under control and they use more relief than preventive medication. Differences in associated factors could determine the outcomes in asthma control among adolescents and their parents.
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Affiliation(s)
| | | | - Lucas Pitrez Mocellin
- Department of Collective Health, Faculty of Medicine, Federal University of Pampa, Brazil
| | - Philippa Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - Luis Garcia-Marcos
- Pediatric Allergy and Pulmonology Units, Arrixaca University Children's Hospital, University of Murcia, IMIB Bio-health Research Institute of Murcia (IMIB), ARADyAL Network, Spain
| | - Laura Simon
- Department of Pediatrics, Federal University of Pampa (Unipampa), Brazil
| | - Pietro Rinelli
- Department of Pediatrics, Federal University of Pampa (Unipampa), Brazil
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, Brazil
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14
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Frontela-Saseta C, González-Bermúdez CA, García-Marcos L. Diet: A Specific Part of the Western Lifestyle Pack in the Asthma Epidemic. J Clin Med 2020; 9:E2063. [PMID: 32630168 PMCID: PMC7408793 DOI: 10.3390/jcm9072063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/22/2020] [Accepted: 06/27/2020] [Indexed: 01/04/2023] Open
Abstract
The Western lifestyle is a complex concept that includes the diet as the main axis of different factors which contribute to a detrimental effect on health, lower life expectancy and low quality-of-life. This type of diet is characterized by being high in calories, mainly provided by saturated fats, and rich in sugars that can lead to changes in immune cells and their responsiveness, by different mechanisms that have yet to be totally clarified. Inflammatory processes are perpetuated through different pathways, in which adipose tissue is a major factor. High fat stores in overweight and obesity accumulate energy but the endocrine function is also producing and releasing different bioactive compounds, adipokines, known to be pro-inflammatory and which play an important role in the pathogenesis of asthma. This review therefore explores the latest evidence regarding the adverse effect of the Western diet on adipose tissue inflammation and its causative effect on the asthma epidemic.
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Affiliation(s)
- Carmen Frontela-Saseta
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Carlos A. González-Bermúdez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Luis García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
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15
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Rosa MJ, Hartman TJ, Adgent M, Gardner K, Gebretsadik T, Moore PE, Davis RL, LeWinn KZ, Bush NR, Tylavsky F, Wright RJ, Carroll KN. Prenatal polyunsaturated fatty acids and child asthma: Effect modification by maternal asthma and child sex. J Allergy Clin Immunol 2019; 145:800-807.e4. [PMID: 31809758 DOI: 10.1016/j.jaci.2019.10.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/08/2019] [Accepted: 10/25/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Findings on prenatal polyunsaturated fatty acid (PUFA) intake and child wheeze and asthma have been inconsistent. OBJECTIVE We sought to examine associations between prenatal PUFA status and child wheeze/asthma and modifying effects of maternal asthma/atopy, child sex, and maternal race. METHODS Analyses included 1019 mother-child dyads with omega-3 (n-3) and omega-3 (n-6) PUFAs measured in second-trimester plasma; n-6/n-3 ratios were calculated. Child wheeze/asthma outcomes ascertained at age 4 to 6 years included ever physician-diagnosed asthma, current wheeze (symptoms past 12 months), current asthma (diagnosis and medication and/or symptoms past 12 months), and current diagnosed asthma. Each PUFA indicator and outcome was analyzed in separate models using modified Poisson regression with interaction terms. RESULTS In quartile (Q) analyses, higher n-6 PUFAs were associated with increased risk of ever (risk ratio [RR] high vs low [RR Q4 vs Q1], 1.70; 95% CI, 1.07-2.71) and current (RR Q4 vs Q1, 1.70; 95% CI, 1.07-2.71) diagnosed asthma, whereas n-3 PUFAs were associated with lower risk (RR Q4 vs Q1, 0.59; 95% CI, 0.33-1.03) of current diagnosed asthma (Ptrend < .05 for all). Higher n-6 PUFAs were associated with a higher risk of all respiratory outcomes among children born to women with asthma (Pinteraction < .05 for all outcomes). A significant 3-way interaction between child sex, maternal asthma, and n-6/n-3 PUFA indicated that male children born to women with asthma and a higher ratio had the highest risk across wheeze/asthma outcomes (Pinteraction < .05). CONCLUSIONS Associations between prenatal PUFA status and childhood wheeze/asthma were modified by maternal history of asthma and child sex.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga
| | - Margaret Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Kourtney Gardner
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Paul E Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Robert L Davis
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, Memphis, Tenn
| | - Kaja Z LeWinn
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, Calif
| | - Nicole R Bush
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of California San Francisco, San Francisco, Calif
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center in Memphis, Memphis, Tenn
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY; Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
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16
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Smoothy J, Larcombe AN, Chivers EK, Matthews VB, Gorman S. Maternal high fat diet compromises survival and modulates lung development of offspring, and impairs lung function of dams (female mice). Respir Res 2019; 20:21. [PMID: 30700289 PMCID: PMC6354360 DOI: 10.1186/s12931-019-0976-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Epidemiological studies have identified strong relationships between maternal obesity and offspring respiratory dysfunction; however, the causal direction is not known. We tested whether maternal obesity alters respiratory function of offspring in early life. Methods Female C57Bl/6 J mice were fed a high or low fat diet prior to and during two rounds of mating and resulting pregnancies with offspring lung function assessed at 2 weeks of age. The lung function of dams was measured at 33 weeks of age. Results A high fat diet caused significant weight gain prior to conception with dams exhibiting elevated fasting glucose, and glucose intolerance. The number of surviving litters was significantly less for dams fed a high fat diet, and surviving offspring weighed more, were longer and had larger lung volumes than those born to dams fed a low fat diet. The larger lung volumes significantly correlated in a linear fashion with body length. Pups born from the second pregnancy had reduced tissue elastance compared to pups born from the first pregnancy, regardless of the dam’s diet. As there was reduced offspring survival born to dams fed a high fat diet, the statistical power of lung function measures of offspring was limited. There were signs of increased inflammation in the bronchoalveolar lavage fluid of dams (but not offspring) fed a high fat diet, with more tumour necrosis factor-α, interleukin(IL)-5, IL-33 and leptin detected. Dams that were fed a high fat diet and became pregnant twice had reduced fasting glucose immediately prior to the second mating, and lower levels of IL-33 and leptin in bronchoalveolar lavage fluid. Conclusions While maternal high fat diet compromised litter survival, it also promoted somatic and lung growth (increased lung volume) in the offspring. Further studies are required to examine downstream effects of this enhanced lung volume on respiratory function in disease settings.
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Affiliation(s)
- Jordan Smoothy
- Telethon Kids Institute, University of Western Australia, Northern Entrance Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia
| | - Alexander N Larcombe
- Telethon Kids Institute, University of Western Australia, Northern Entrance Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia.,School of Public Health, Curtin University, Perth, Western Australia, 6845, Australia
| | - Emily K Chivers
- Telethon Kids Institute, University of Western Australia, Northern Entrance Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia
| | - Vance B Matthews
- School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Northern Entrance Perth Children's Hospital, 15 Hospital Ave, Nedlands, Western Australia, 6009, Australia.
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Nyenhuis SM, Dixon AE, Ma J. Impact of Lifestyle Interventions Targeting Healthy Diet, Physical Activity, and Weight Loss on Asthma in Adults: What Is the Evidence? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:751-763. [PMID: 29221919 PMCID: PMC5948112 DOI: 10.1016/j.jaip.2017.10.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/10/2017] [Accepted: 10/26/2017] [Indexed: 02/07/2023]
Abstract
Unhealthy lifestyle factors such as poor diet quality, sedentary lifestyle, and obesity are associated with negative health consequences in asthma including poor asthma control, impaired quality of life, and greater health care utilization. Lifestyle modification is the cornerstone of behavioral treatments and has been effective in chronic diseases such as atherothrombotic vascular disease and diabetes. There is a critical need for lifestyle interventions in asthma care that address obesity and its intimately linked risk behaviors in terms of poor diet and physical inactivity. We present in this commentary the promising lifestyle interventions emerging in asthma care that target poor diet, physical inactivity and weight loss, the proposed mechanisms of these lifestyle interventions, and the critical need for guideline-concordant lifestyle interventions in asthma care.
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Affiliation(s)
- Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Ill.
| | - Anne E Dixon
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vt
| | - Jun Ma
- Department of Health Policy and Administration, Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Ill
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18
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Wypych TP, Marsland BJ. Antibiotics as Instigators of Microbial Dysbiosis: Implications for Asthma and Allergy. Trends Immunol 2018; 39:697-711. [PMID: 29655522 DOI: 10.1016/j.it.2018.02.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 02/07/2023]
Abstract
The human body and its resident microbiota form a complex ecosystem, shaped by both inherited and environmental factors. The use of antibiotics represents an extreme example of environmental pressure and can broadly disrupt the microbial landscape. The benefits that antibiotics have brought to modern medicine are unquestionable; however, their overuse comes with consequences, including the potential for secondary infections by opportunistic pathogens and the spread of antibiotic resistance. Here, we discuss the implications of microbial dysbiosis driven by antibiotics, with a focus on potential links with allergy and asthma. We review epidemiological data on humans, as well as mechanistic studies performed in animal models, and highlight gaps in current knowledge, which if addressed, could drive the design of novel therapeutic strategies and improved clinical care.
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Affiliation(s)
- Tomasz P Wypych
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Epalinges, Switzerland.
| | - Benjamin J Marsland
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Epalinges, Switzerland; Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia.
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Wright LS, Rifas-Shiman SL, Oken E, Litonjua AA, Gold DR. Prenatal and Early Life Fructose, Fructose-Containing Beverages, and Midchildhood Asthma. Ann Am Thorac Soc 2018; 15:217-224. [PMID: 29219619 PMCID: PMC5802621 DOI: 10.1513/annalsats.201707-530oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/08/2017] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Cross-sectional studies have linked intake of high-fructose corn syrup-sweetened beverages with asthma in schoolchildren. OBJECTIVES To examine associations of maternal prenatal and early childhood intake of sugar-sweetened beverages and fructose with current asthma in midchildhood (median age, 7.7 yr). METHODS We assessed maternal pregnancy (first- and second-trimester average) and child (median age, 3.3 yr) intake of sugar-sweetened beverages and total fructose using food frequency questionnaires in 1,068 mother-child pairs from Project Viva, a prospective prebirth cohort. In a multivariable analysis, we examined associations of quartiles of maternal and child sugar-sweetened beverage, juice, and total fructose intake with child current asthma in midchildhood, assessed by questionnaire as ever having doctor-diagnosed asthma plus taking asthma medications or reporting wheezing in the past 12 months. RESULTS Higher maternal pregnancy sugar-sweetened beverage consumption (mean, 0.6 servings/d; range, 0-5) was associated with younger maternal age, nonwhite race/ethnicity, lower education and income, and higher prepregnancy body mass index. Adjusting for prepregnancy body mass index and other covariates, comparing quartile 4 with quartile 1, higher maternal pregnancy intake of sugar-sweetened beverages (odds ratio, 1.70; 95% confidence interval, 1.08-2.67) and total fructose (odds ratio, 1.58; 95% confidence interval, 0.98-2.53) were associated with greater odds of midchildhood current asthma (prevalence, 19%). Higher early childhood fructose intake (quartile 4 vs. quartile 1) was also associated with midchildhood current asthma in models adjusted for maternal sugar-sweetened beverages (odds ratio, 1.79; 95% confidence interval, 1.07-2.97) and after additional adjustment for midchildhood body mass index z-score (odds ratio, 1.77; 95% confidence interval, 1.06-2.95). CONCLUSIONS Higher sugar-sweetened beverage and fructose intake during pregnancy and in early childhood was associated with childhood asthma development independent of adiposity.
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Affiliation(s)
- Lakiea S. Wright
- Division of Rheumatology, Immunology, and Allergy
- Division of Immunology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts; and
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Augusto A. Litonjua
- Channing Division of Network Medicine, and
- Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Diane R. Gold
- Channing Division of Network Medicine, and
- Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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20
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Dietary vitamin D3 deficiency exacerbates sinonasal inflammation and alters local 25(OH)D3 metabolism. PLoS One 2017; 12:e0186374. [PMID: 29045457 PMCID: PMC5646812 DOI: 10.1371/journal.pone.0186374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/30/2017] [Indexed: 12/21/2022] Open
Abstract
RATIONALE Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have been shown to be vitamin D3 (VD3) deficient, which is associated with more severe disease and increased polyp size. To gain mechanistic insights into these observational studies, we examined the impact of VD3 deficiency on inflammation and VD3 metabolism in an Aspergillus fumigatus (Af) mouse model of chronic rhinosinusitis (Af-CRS). METHODS Balb/c mice were fed control or VD3 deficient diet for 4 weeks. Mice were then sensitized with intraperitoneal Af, and one week later given Af intranasally every three days for four weeks while being maintained on control or VD3 deficient diet. Airway function, sinonasal immune cell infiltrate and sinonasal VD3 metabolism profiles were then examined. RESULTS Mice with VD3 deficiency had increased Penh and sRaw values as compared to controls as well as exacerbated changes in sRaw when coupled with Af-CRS. As compared to controls, VD3 deficient and Af-CRS mice had reduced sinonasal 1α-hydroxylase and the active VD3 metabolite, 1,25(OH)2D3. Differential analysis of nasal lavage samples showed that VD3 deficiency alone and in combination with Af-CRS profoundly upregulated eosinophil, neutrophil and lymphocyte numbers. VD3 deficiency exacerbated increases in monocyte-derived dendritic cell (DC) associated with Af-CRS. Conversely, T-regulatory cells were decreased in both Af-CRS mice and VD3 deficient mice, though coupling VD3 deficiency with Af-CRS did not exacerbate CD4 or T-regulatory cells numbers. Lastly, VD3 deficiency had a modifying or exacerbating impact on nasal lavage levels of IFN-γ, IL-6, IL-10 and TNF-α, but had no impact on IL-17A. CONCLUSIONS VD3 deficiency causes changes in sinonasal immunity, which in many ways mirrors the changes observed in Af-CRS mice, while selectively exacerbating inflammation. Furthermore, both VD3 deficiency and Af-CRS were associated with altered sinonasal VD3 metabolism causing reductions in local levels of the active VD3 metabolite, 1,25(OH)2D3, even with adequate circulating levels.
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21
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Wypych TP, Marsland BJ. Diet Hypotheses in Light of the Microbiota Revolution: New Perspectives. Nutrients 2017; 9:nu9060537. [PMID: 28538698 PMCID: PMC5490516 DOI: 10.3390/nu9060537] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/12/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023] Open
Abstract
From an evolutionary standpoint, allergy has only recently emerged as a significant health problem. Various hypotheses were proposed to explain this, but they all indicated the importance of rapid lifestyle changes, which occurred in industrialized countries in the last few decades. In this review, we discuss evidence from epidemiological and experimental studies that indicate changes in dietary habits may have played an important role in this phenomenon. Based on the example of dietary fiber, we discuss molecular mechanisms behind this and point towards the importance of diet-induced changes in the microbiota. Finally, we reason that future studies unraveling mechanisms governing these changes, along with the development of better tools to manipulate microbiota composition in individuals will be crucial for the design of novel strategies to combat numerous inflammatory disorders, including atopic diseases.
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Affiliation(s)
- Tomasz P Wypych
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Epalinges 1066, Switzerland.
| | - Benjamin J Marsland
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Epalinges 1066, Switzerland.
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22
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Prakash YS. Emerging concepts in smooth muscle contributions to airway structure and function: implications for health and disease. Am J Physiol Lung Cell Mol Physiol 2016; 311:L1113-L1140. [PMID: 27742732 DOI: 10.1152/ajplung.00370.2016] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/06/2016] [Indexed: 12/15/2022] Open
Abstract
Airway structure and function are key aspects of normal lung development, growth, and aging, as well as of lung responses to the environment and the pathophysiology of important diseases such as asthma, chronic obstructive pulmonary disease, and fibrosis. In this regard, the contributions of airway smooth muscle (ASM) are both functional, in the context of airway contractility and relaxation, as well as synthetic, involving production and modulation of extracellular components, modulation of the local immune environment, cellular contribution to airway structure, and, finally, interactions with other airway cell types such as epithelium, fibroblasts, and nerves. These ASM contributions are now found to be critical in airway hyperresponsiveness and remodeling that occur in lung diseases. This review emphasizes established and recent discoveries that underline the central role of ASM and sets the stage for future research toward understanding how ASM plays a central role by being both upstream and downstream in the many interactive processes that determine airway structure and function in health and disease.
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Affiliation(s)
- Y S Prakash
- Departments of Anesthesiology, and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
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Blonstein AC, Lv N, Camargo CA, Wilson SR, Buist AS, Rosas LG, Strub P, Ma J. Acceptability and feasibility of the 'DASH for Asthma' intervention in a randomized controlled trial pilot study. Public Health Nutr 2016; 19:2049-59. [PMID: 26653101 PMCID: PMC10270885 DOI: 10.1017/s136898001500350x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 10/02/2015] [Accepted: 11/10/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE 'DASH for Asthma' (n 90) was a 6-month randomized controlled trial that demonstrated potential benefits of a DASH (Dietary Approaches to Stop Hypertension) behavioural intervention for improving diet quality and asthma control by comparing intervention to usual care in adults with uncontrolled asthma. The present study examined acceptability and feasibility of the intervention from the perspective of intervention participants and lifestyle coaches. DESIGN Grounded in Social Cognitive Theory, the 3-month intensive stage, including three individual and eight group sessions, focused on diet modifications and behavioural self-regulation. The 3-month maintenance stage contained telephone consultations. Participants and lifestyle coaches completed surveys including 5-point Likert scales and open-ended questions. We analysed data using descriptive and inductive content analyses. SUBJECTS Forty-six intervention participants (survey response rate was 65-72 %) and two lifestyle coaches. RESULTS Participants and lifestyle coaches were highly satisfied (all mean ratings >4) with individual and group sessions. Participants identified mastery of knowledge and skills (awareness, goal setting, self-monitoring, problem solving), social learning (class members sharing experiences and ideas) and good coaching skills (reflective listening, empathy, motivational counselling) as important contributors to self-efficacy and programme satisfaction. Participants also valued personalized feedback received in individual sessions. Lifestyle coaches viewed participant engagement as a facilitator to effective sessions. Finally, participants and lifestyle coaches identified food tasting as beneficial for observational learning and facilitation of participant engagement. High class attendance and self-monitoring rate also reflected the high engagement among participants. CONCLUSIONS The DASH behavioural intervention was feasible and highly acceptable to participants with uncontrolled asthma and lifestyle coaches.
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Affiliation(s)
| | - Nan Lv
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra R Wilson
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - A Sonia Buist
- Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Lisa G Rosas
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Peg Strub
- Department of Allergy, Asthma, and Immunology, The Permanente Medical Group, San Francisco Medical Center, San Francisco, CA, USA
| | - Jun Ma
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Health Policy and Administration, University of Illinois at Chicago School of Public Health, Chicago, IL 60607, USA
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Sheth A, Asher MI, Ellwood P, Ellwood E. Can geodata be used to determine the distribution of fast food outlets in relation to the prevalence and severity of asthma? A novel methodology. Allergol Immunopathol (Madr) 2016; 44:307-13. [PMID: 26589338 DOI: 10.1016/j.aller.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/16/2015] [Indexed: 01/04/2023]
Abstract
RESEARCH QUESTION Can the distribution of fast food outlets be obtained and effectively used to identify if there is a relationship between the placement of these and the prevalence and severity of asthma, rhinoconjunctivitis and eczema (ARE) in children and adolescents? METHOD Fast food restaurant location data was obtained for seven countries. Data from the International Study of Asthma and Allergies in Childhood (ISAAC) was used from 53 centres in the same seven countries. Each ISAAC centre provided a detailed map of the study area. The location of restaurants and ISAAC centres were overlaid using the ArcMap software, and the number of restaurants within each ISAAC centre counted. Bivariate regression analysis was used to compare outlet density with ARE prevalence and severity. RESULTS The results from the analyses showed a positive (non-significant) trend on a regression plot between outlet density and ARE severity. This project has shown that it is practical to systematically obtain and map fast food outlets and compare their distribution worldwide with the prevalence and severity of diseases, in this case ARE. The devised methodology has proven to be an efficient way to obtain restaurant distribution data in a form that is manageable and suitable to compare with area based disease prevalences. This project has shown that a larger scale investigation is both feasible and warranted.
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Affiliation(s)
- A Sheth
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand.
| | - M I Asher
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - P Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - E Ellwood
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
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Kryštofová J, Jeseňák M, Bánovčin P. Bronchial Asthma and Obesity in Childhood. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016. [DOI: 10.14712/18059694.2016.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Bronchial asthma and obesity is among a group of multietiologic complex diseases which influence each other in their origin, and development. The impact on the patient‘s quality of life and prognosis is significant, health costs included. Because of the increasing prevalence worldwide, there has been an increase in the amount of studies dealing with reciprocal associations between asthma and obesity.
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Pries AM, Huffman SL, Mengkheang K, Kroeun H, Champeny M, Roberts M, Zehner E. Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding. MATERNAL & CHILD NUTRITION 2016; 12 Suppl 2:38-51. [PMID: 27061955 PMCID: PMC5071766 DOI: 10.1111/mcn.12271] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED In 2005, Cambodia passed the Sub-Decree on Marketing of Products for Infant and Young Child Feeding (no. 133) to regulate promotion of commercial infant and young child food products, including breastmilk substitutes. Helen Keller International assessed mothers' exposure to commercial promotions for breastmilk substitutes and use of these products through a cross-sectional survey among 294 mothers of children less than 24 months of age. Eighty-six per cent of mothers reported observing commercial promotions for breastmilk substitutes, 19.0% reported observing infant and young child food product brands/logos on health facility equipment and 18.4% reported receiving a recommendation from a health professional to use a breastmilk substitute. Consumption of breastmilk substitutes was high, occurring among 43.1% of children 0-5 months and 29.3% of children 6-23 months of age. Findings also indicated a need to improve breastfeeding practices among Phnom Penh mothers. Only 36.1% of infants 0-5 months of age were exclusively breastfed, and 12.5% of children 20-23 months of age were still breastfed. Children that received a breastmilk substitute as a prelacteal feed were 3.9 times more likely to be currently consuming a breastmilk substitute than those who did not. Despite restriction of commercial promotions for breastmilk substitutes without government approval, occurrence of promotions is high and use is common among Phnom Penh mothers. In a country with high rates of child malnutrition and pervasive promotions in spite of restrictive national law, full implementation of Cambodia's Sub-Decree 133 is necessary, as are policies and interventions to support exclusive and continued breastfeeding. KEY MESSAGES Despite prohibition without specific approval by the national government, companies are pervasively promoting breast-milk substitutes in Phnom Penh, particularly on television and at points of sale. Strengthened implementation and enforcement of Cambodia's subdecree 133 are needed to better regulate promotion in order to protect breastfeeding for the nutrition and health of infants and young children in Cambodia. Mothers who used a breast-milk substitute as a prelacteal feed were 3.9 times more likely to currently feed this same child a breast-milk substitute, as compared with mothers who did not provide breast-milk substitute as a prelacteal feed. Supporting breastfeeding among mothers after delivery is critical to establish and sustain optimal breastfeeding practices. Use of breast-milk substitutes is also very common among mothers of children under 2 years of age in Phnom Penh. We recommend promoting exclusive and continued breastfeeding as beneficial to children's health and development, and supporting policy and workplace environments that enable breastfeeding up to and beyond 24 months of age.
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Affiliation(s)
- Alissa M. Pries
- Helen Keller InternationalAsia Pacific Regional OfficePhnom PenhCambodia
| | | | | | - Hou Kroeun
- Helen Keller InternationalPhnom PenhCambodia
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Sonik RA. Massachusetts Inpatient Medicaid Cost Response to Increased Supplemental Nutrition Assistance Program Benefits. Am J Public Health 2016; 106:443-8. [PMID: 26794167 PMCID: PMC4880217 DOI: 10.2105/ajph.2015.302990] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the impact of an increase in Supplemental Nutrition Assistance Program (SNAP) benefits on Medicaid costs and use in Massachusetts. METHODS Using single and multigroup interrupted time series models, I examined the effect of an April 2009 increase in SNAP benefits on inpatient Medicaid cost and use patterns. I analyzed monthly Medicaid discharge data from 2006 to 2012 collected by the Massachusetts Center for Health Information and Analysis. RESULTS Inpatient costs for the overall Massachusetts Medicaid population grew by 0.55 percentage points per month (P < .001) before the SNAP increase. After the increase, cost growth fell by 73% to 0.15 percentage points per month (-0.40; P = .003). Compared with the overall Medicaid population, cost growth for people with the selected chronic illnesses was significantly greater before the SNAP increase, as was the decline in growth afterward. Reduced hospital admissions after the SNAP increase drove the cost declines. CONCLUSIONS Medicaid cost growth fell in Massachusetts after SNAP benefits increased, especially for people with chronic illnesses with high sensitivity to food insecurity.
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Affiliation(s)
- Rajan Anthony Sonik
- Rajan Anthony Sonik is with the Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA
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The potential link between sugar-sweetened beverage consumption and post-exercise airway narrowing across puberty: a longitudinal cohort study. Public Health Nutr 2015; 19:2435-40. [PMID: 26514591 DOI: 10.1017/s1368980015003109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of asthma is rising, presenting serious public health challenges. Recent data suggest that sugar-sweetened beverage (SSB) consumption plays a role in asthma aetiology. The purpose of the present study was to determine whether SSB consumption is linked to post-exercise airway narrowing (predictor of asthma development) across puberty. DESIGN Participants completed pulmonary function tests, physical activity and dietary habit questionnaires, and an exercise test to exhaustion. SETTING Community in Manhattan, Kansas, USA. SUBJECTS We recruited ten boys and ten girls from an original cohort of forty participants tested in our laboratory approximately 5 years prior. Participants were aged 9·7 (sd 0·9) years at baseline and 14·7 (sd 0·9) years at follow-up. RESULTS Pre-puberty, boys consumed 6·8 (sd 4·8) servings/week and girls consumed 6·9 (sd 3·7) servings/week, while post-puberty boys consumed 11·5 (sd 5·3) servings/week and girls consumed 7·7 (sd 4·3) servings/week. Using Pearson correlation, SSB consumption was not significantly related to post-exercise airway narrowing at pre-puberty (r=-0·35, P=0·130). In linear regression analyses, SSB consumption was significantly related to post-exercise airway narrowing post-puberty before (standardized β=-0·60, P=0·005) but not after (standardized β=-0·33, P=0·211) adjustment for confounders. Change in SSB consumption from pre- to post-puberty was significantly associated with post-exercise airway narrowing post-puberty (r=-0·61, P=0·010) and change in post-exercise airway narrowing from pre- to post-puberty (r=-0·45, P=0·048) when assessed via Pearson correlations. CONCLUSIONS These findings suggest a possible link between SSB consumption and asthma development during maturation. Reduced SSB intake may be a possible public health avenue for blunting rising asthma prevalence.
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von Ehrenstein OS, Aralis H, Flores MES, Ritz B. Fast food consumption in pregnancy and subsequent asthma symptoms in young children. Pediatr Allergy Immunol 2015; 26:571-7. [PMID: 26109272 DOI: 10.1111/pai.12433] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent cross-sectional studies suggested children's current fast food consumption to be related to frequency of asthma and allergies. Maternal prenatal diet has been suspected to contribute to children's asthma and atopic disease risks. OBJECTIVES We hypothesized that maternal fast food intake during pregnancy increases offspring's risk for asthmatic symptoms. METHODS We conducted a population-based study of 1201 mother/child pairs in Los Angeles, California. Detailed information about prenatal fast food intake and other dietary, lifestyle/environmental factors, and pregnancy was collected shortly after birth; further data were retrieved from birth certificates. Using the International Study of Asthma and Allergies in Childhood core questions, asthma and rhinitis symptoms were assessed, and doctor's diagnoses were recorded in offspring 3.5 years after birth. Poisson regression with robust error variance using a log link function was used to estimate relative risks (RRs). Models were adjusted using covariates or propensity scores. RESULTS Maternal prenatal fast food consumption related to increased relative risks of their children for severe, and current asthma symptoms (wheeze last 12 months combined with doctor's diagnosis) in a dose-dependent manner: 'once a month': RR: 0.99 (95% CI: 0.36, 2.75), 'once a week': 1.26 (0.47, 3.34); '3-4 days a week': 2.17 (0.77, 6.12); and 'every day' 4.46 (1.36 14.6) compared to 'never', adjusting for potential confounders (p for trend = 0.0025). There was also suggestion of increased risks for rhinitis symptoms. CONCLUSIONS These findings suggest that in utero exposure to frequent fast food through maternal diet may be a risk factor for asthmatic symptoms in young children.
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Affiliation(s)
- O S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - H Aralis
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - M E S Flores
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Department of Family and Social Medicine, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, NY, USA
| | - B Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Silva Ibrahim B, Miranda da Silva C, Barioni ÉD, Correa-Costa M, Drewes CC, Saraiva Câmara NO, Tavares-de-Lima W, Poliselli Farsky SH, Lino-dos-Santos-Franco A. Formaldehyde inhalation during pregnancy abolishes the development of acute innate inflammation in offspring. Toxicol Lett 2015; 235:147-54. [DOI: 10.1016/j.toxlet.2015.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
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Berthon BS, Wood LG. Nutrition and respiratory health--feature review. Nutrients 2015; 7:1618-43. [PMID: 25751820 PMCID: PMC4377870 DOI: 10.3390/nu7031618] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 01/08/2023] Open
Abstract
Diet and nutrition may be important modifiable risk factors for the development, progression and management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). This review examines the relationship between dietary patterns, nutrient intake and weight status in obstructive lung diseases, at different life stages, from in-utero influences through childhood and into adulthood. In vitro and animal studies suggest important roles for various nutrients, some of which are supported by epidemiological studies. However, few well-designed human intervention trials are available to definitively assess the efficacy of different approaches to nutritional management of respiratory diseases. Evidence for the impact of higher intakes of fruit and vegetables is amongst the strongest, yet other dietary nutrients and dietary patterns require evidence from human clinical studies before conclusions can be made about their effectiveness.
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Affiliation(s)
- Bronwyn S Berthon
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - Lisa G Wood
- Centre for Asthma and Respiratory Diseases, Level 2, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
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Schröder PC, Li J, Wong GWK, Schaub B. The rural-urban enigma of allergy: what can we learn from studies around the world? Pediatr Allergy Immunol 2015; 26:95-102. [PMID: 25620193 DOI: 10.1111/pai.12341] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 12/27/2022]
Abstract
Childhood asthma and related allergic conditions have become the most common chronic disorders in the Western world. Many studies from around the world have demonstrated an increasing trend of asthma prevalence over the last few decades (Lancet, 368, 2004, 733). A few recent reports also suggested that childhood asthma prevalence may be showing a plateau or even a decline in few developed countries. Given the rapid changes in the prevalence over a short period of time, environmental factors are the more likely candidates explaining such trend. One of the most consistent epidemiological findings was that subjects living in the rural areas had lower prevalence of allergies when compared to those from urban areas (Clin Exp Allergy 30, 2000, 187; Pediatr Pulmonol 44, 2009, 793). Clear understanding of the mechanisms of how the environmental determinants in the rural environment may affect the early immune system resulting in lower risk of allergies and asthma will facilitate the development of future primary preventive strategies. In this study, we review recent data from around the world and explore the epidemiology and mechanistic studies that may explain the rural-urban difference of allergies.
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Affiliation(s)
- Paul C Schröder
- LMU Munich, University Children's Hospital, Munich, Germany; Member of the German Center for Lung Research (DZL), Munich, Germany
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Ding G, Ji R, Bao Y. Risk and protective factors for the development of childhood asthma. Paediatr Respir Rev 2015; 16:133-9. [PMID: 25155282 DOI: 10.1016/j.prrv.2014.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/31/2014] [Accepted: 07/27/2014] [Indexed: 10/25/2022]
Abstract
Childhood asthma prevalence worldwide has been increasing markedly over several decades. Various theories have been proposed to account for this alarming trend. The disease has a broad spectrum of potential determinants ranging from genetics to lifestyle and environmental factors. Epidemiological observations have demonstrated that several important lifestyle and environmental factors including obesity, urban living, dietary patterns such as food low in antioxidants and fast food, non-breastfeeding, gut flora imbalance, cigarette smoking, air pollution, and viral infection are associated with asthma exacerbations in children. However, only environmental tobacco smoke has been associated with the development of asthma. Despite epidemiological studies indicating that many other factors are probably associated with the development of asthma, the relationships are not considered causal due to the inadequate evidence and inconsistent results from recent studies. This may highlight that sufficient data and exact mechanisms of causality are still in need of further study.
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Affiliation(s)
- Guodong Ding
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environment Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoxu Ji
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixiao Bao
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Editorials. Indian Pediatr 2015. [DOI: 10.1007/s13312-015-0560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nkosi V, Wichmann J, Voyi K. Mine dumps, wheeze, asthma, and rhinoconjunctivitis among adolescents in South Africa: any association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 25:583-600. [PMID: 25537069 PMCID: PMC4673552 DOI: 10.1080/09603123.2014.989493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 10/20/2014] [Indexed: 05/29/2023]
Abstract
The study investigated the association between community proximity to mine dumps, and current wheeze, rhinoconjunctivitis, and asthma among adolescents. This study was conducted during May-November 2012 around five mine dumps in South Africa. Communities in close proximity to mine dumps had an increased likelihood of current wheeze OR 1.38 (95 % CI: 1.10-1.71), rhinoconjunctivitis OR 1.54 (95 % CI: 1.29-1.82), and a protective association with asthma OR 0.29 (95 % CI: 0.23-0.35). Factors associated with health outcomes included other indoor and outdoor pollution sources. Wheeze and rhinoconjunctivitis appear to be a public health problem in these communities. The findings of this study serve as a base for further detailed epidemiological studies for communities in close proximity to the mine dumps e.g. a planned birth cohort study.
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Affiliation(s)
- Vusumuzi Nkosi
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Kuku Voyi
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Brigham EP, Kolahdooz F, Hansel N, Breysse PN, Davis M, Sharma S, Matsui EC, Diette G, McCormack MC. Association between Western diet pattern and adult asthma: a focused review. Ann Allergy Asthma Immunol 2014; 114:273-80. [PMID: 25524748 DOI: 10.1016/j.anai.2014.11.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/07/2014] [Accepted: 11/11/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Radical changes in diet have paralleled the increase in asthma with shifts toward a "Western" diet pattern, characterized by the high intake of processed meats and refined grains, high-fat dairy products, and sugary desserts and drinks. Because diet represents a modifiable risk factor in numerous chronic diseases, the authors examined the association between consumption of a Western diet pattern and asthma incidence, prevalence, and morbidity in adults. DATA SOURCES PubMed, Cochrane, Web of Science, and Scopus were searched for peer-reviewed publications published from January 1980 to April 2014. STUDY SELECTION Studies retrieved for inclusion assessed dietary patterns representative of a Western diet and asthma incidence, prevalence, respiratory symptoms, and lung function. RESULTS Ten observational studies conducted in North American, European, and Asian countries, ranging from 153 to more than 70,000 individuals, did not provide evidence to support an association between a Western dietary pattern and asthma incidence and prevalence. Five of these studies also investigated asthma morbidity, with variable findings. CONCLUSION Current evidence does not support an association between a Western diet and incident or prevalent adult asthma but does suggest a possible link between a Western diet pattern and adult asthma morbidity.
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Affiliation(s)
- Emily P Brigham
- The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fariba Kolahdooz
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Hansel
- The Johns Hopkins University School of Medicine, Baltimore, Maryland; The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Patrick N Breysse
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Meghan Davis
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sangita Sharma
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Elizabeth C Matsui
- The Johns Hopkins University School of Medicine, Baltimore, Maryland; The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gregory Diette
- The Johns Hopkins University School of Medicine, Baltimore, Maryland; The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Meredith C McCormack
- The Johns Hopkins University School of Medicine, Baltimore, Maryland; The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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Akcay A, Tamay Z, Hocaoglu A, Ergin A, Guler N. Risk factors affecting asthma prevalence in adolescents living in Istanbul, Turkey. Allergol Immunopathol (Madr) 2014; 42:449-58. [PMID: 23969072 DOI: 10.1016/j.aller.2013.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Asthma is one of the most important diseases of childhood. The aim of this study was to evaluate the prevalence of asthma symptoms and risk factors affecting asthma. METHODS In a cross-sectional study design, 9991 children, aged 13-14 years in 61 primary schools in 32 districts of Istanbul were evaluated. Asthma prevalence among the children was assessed using the ISAAC protocol. RESULTS In our study, a total of 10,894 questionnaires were distributed to 13-14 years old children, and of these 9991 questionnaires were suitable for analysis with an overall response rate of 91.7%. The rates of wheeze ever, wheezing in last 12 months and lifetime doctor diagnosed asthma prevalence were 17.4%, 9.0%, and 11.8%, respectively. There were 4746 boys (47.9%) and 5166 girls (52.1%) with M/F ratio of 0.92. Atopic family history, fewer than three siblings living at home, tonsillectomy or adenoidectomy history, consumption of fermented foods, mixed pickles, margarine and meat were found to be associated with an increased asthma risk. Use of paracetamol in the last 12 months, consumption of fruit and animal fats acted as a protective factor against asthma. The Mediterranean-style diet was not associated with the prevalence of asthma. CONCLUSIONS Lifetime doctor diagnosed asthma prevalence was found to be 11.8% in 13-14 year olds. History of tonsillectomy and/or adenoidectomy and consumption of fermented foods, mixed pickles, margarine and meat may increase the symptoms of asthma. Usage of paracetamol and consumption of animal fats may be investigated as a protective factor against asthma.
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Lv N, Xiao L, Ma J. Dietary pattern and asthma: a systematic review and meta-analysis. J Asthma Allergy 2014; 7:105-21. [PMID: 25143747 PMCID: PMC4137988 DOI: 10.2147/jaa.s49960] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The literature on the relationship between diet and asthma has largely focused on individual nutrients, with conflicting results. People consume a combination of foods from various groups that form a dietary pattern. Studying the role of dietary patterns in asthma is an emerging area of research. The purpose of this study was to systematically review dietary patterns and asthma outcomes in adults and children, to review maternal diet and child asthma, and to conduct a meta-analysis on the association between asthma prevalence and dietary patterns in adults. Methods We searched Medline, Scopus, and ISI Web of Knowledge up to January 2014. Two researchers independently reviewed studies meeting the inclusion criteria using the American Dietetic Association quality criteria. A linear mixed model was used to derive the pooled effect size (95% confidence interval) for each of three dietary pattern categories (healthy, unhealthy, and neutral). Results Thirty-one studies were identified (16 cross-sectional, one case-control, 13 cohort, and one randomized controlled trial), including 12 in adults, 13 in children, five in pregnant woman–child pairs, and one in both children and pregnant woman–child pairs. Six of the 12 adult studies reported significant associations between dietary patterns and asthma outcomes (eg, ever asthma and forced expiratory volume in one second). Seven of ten studies examining the Mediterranean diet showed protective effects on child asthma and/or wheeze. Four of the six studies in mother-child pairs showed that maternal dietary patterns during pregnancy were not associated with child asthma or wheeze. The meta-analysis including six adult studies, the primary outcome of which was the prevalence of current or ever asthma, showed no association with healthy, unhealthy, or neutral dietary patterns. Conclusion The evidence suggests no association of dietary patterns with asthma prevalence in adults or of maternal diet with child asthma or wheeze. The Mediterranean diet in children may prevent asthma or wheeze, but randomized controlled trials are lacking.
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Affiliation(s)
- Nan Lv
- Palo Alto Medical Foundation Research Institute, Stanford, CA, USA
| | - Lan Xiao
- Palo Alto Medical Foundation Research Institute, Stanford, CA, USA
| | - Jun Ma
- Palo Alto Medical Foundation Research Institute, Stanford, CA, USA ; Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Abstract
The human fetus lives in a germ-free intrauterine environment and enters the outside world containing microorganisms from several sources, resulting in gut colonization. Full-term, vaginally born infants are completely colonized with a diverse array of bacterial families in clusters (Phyla) and species (>1000) by the first year of life. Colonizing bacteria communicating with the gut epithelium and underlying lymphoid tissues ('bacterial-epithelial crosstalk') result in a functional immune phenotype and no expression of disease (immune homeostasis). Appropriate colonization is influenced by the prebiotic effect of breast milk oligosaccharides. Adequate colonization results in an innate and adaptive mucosal immune phenotype via communication between molecular patterns on colonizing bacteria and pattern-recognition receptors (e.g., toll-like receptors) on epithelial and lymphoid cells. This ontogeny affects the immune system's capacity to develop oral tolerance to innocuous bacteria and benign antigens. Inadequate intestinal colonization with premature delivery, delivery by Cesarean section and excessive use of perinatal antibiotics results in the absence of adequate bacterial-epithelial crosstalk and an increased incidence of immune-mediated diseases [e.g., asthma, allergy in general and necrotizing enterocolitis (NEC)]. Fortunately, infants with inadequate intestinal colonization can be restored to a bacterial balance with the intake of probiotics. This has been shown to prevent debilitating diseases such as NEC. Thus, understanding the role of gut microbiota in programming of the immune phenotype may be important in preventing disease expression in later childhood and adulthood.
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Allergic diseases: the price of civilisational progress. Postepy Dermatol Alergol 2014; 31:77-83. [PMID: 25097472 PMCID: PMC4112251 DOI: 10.5114/pdia.2014.40936] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 09/26/2013] [Accepted: 09/28/2013] [Indexed: 12/22/2022] Open
Abstract
Atopic disorders are a major global health problem. The prevalence of asthma, allergic rhinitis and atopic dermatitis has been increasing over the last four decades, both in the industrialized and developing countries. It seems to be related to changes in the social structure, increasing industrialization, pollution and dietary changes. Many hypotheses link the allergy epidemic to stringent hygiene, dominance of a westernized lifestyle and an accelerated pace of life. Dietary antioxidants, lipids, sodium, vitamin D seem also to be implicated. We endeavour to review the most relevant theories with a special emphasis on the hygiene, antioxidative, lipid and air pollution hypotheses. It is however important to note that none of them explains all the aspects of unprecedented rise in the prevalence of allergic disorders. A complex interplay between host's immune response, invading pathogens, diversity of environmental factors and genetic background seems to be of a particular importance. Current allergy epidemic is multifactorial and basic and epidemiologic studies are warranted to further our understanding of this phenomenon.
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Brown SB, Reeves KW, Bertone-Johnson ER. Maternal folate exposure in pregnancy and childhood asthma and allergy: a systematic review. Nutr Rev 2014; 72:55-64. [PMID: 24551950 DOI: 10.1111/nure.12080] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Adequate folate status in early pregnancy is critical to prevent congenital malformations, yet little is known about whether exposure to folate, specifically folic acid supplementation beyond the recommended dose, influences chronic health outcomes. The link between maternal folate levels and risk of childhood asthma and allergic disease has been investigated in 10 large prospective cohort studies that reported conflicting results. While the majority of studies reported no association, those supporting a positive relationship found a small increase in risk that was generally transient in nature, confined to early childhood, and associated with folic acid supplementation in late pregnancy. This systematic review presents background information on maternal folate exposure and childhood asthma, synthesizes the current epidemiologic evidence in the context of the methodological differences among studies and their potential limitations, and offers direction for future research.
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Ma J, Strub P, Lavori PW, Buist AS, Camargo CA, Nadeau KC, Wilson SR, Xiao L. DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma. Contemp Clin Trials 2013; 35:55-67. [PMID: 23648395 PMCID: PMC4217513 DOI: 10.1016/j.cct.2013.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 01/03/2023]
Abstract
This pilot study aims to provide effect size confidence intervals, clinical trial and intervention feasibility data, and procedural materials for a full-scale randomized controlled trial that will determine the efficacy of Dietary Approaches to Stop Hypertension (DASH) as adjunct therapy to standard care for adults with uncontrolled asthma. The DASH diet encompasses foods (e.g., fresh fruit, vegetables, and nuts) and antioxidant nutrients (e.g., vitamins A, C, E, and zinc) with potential benefits for persons with asthma, but it is unknown whether the whole diet is beneficial. Participants (n = 90) will be randomized to receive usual care alone or combined with a DASH intervention consisting of 8 group and 3 individual sessions during the first 3 months, followed by at least monthly phone consultations for another 3 months. Follow-up assessments will occur at 3 and 6 months. The primary outcome measure is the 7-item Juniper Asthma Control Questionnaire, a validated composite measure of daytime and nocturnal symptoms, activity limitations, rescue medication use, and percentage predicted forced expiratory volume in 1 second. We will explore changes in inflammatory markers important to asthma pathophysiology (e.g., fractional exhaled nitric oxide) and their potential to mediate the intervention effect on disease control. We will also conduct pre-specified subgroup analyses by genotype (e.g., polymorphisms on the glutathione S transferase gene) and phenotype (e.g., atopy, obesity). By evaluating a dietary pattern approach to improving asthma control, this study could advance the evidence base for refining clinical guidelines and public health recommendations regarding the role of dietary modifications in asthma management.
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Affiliation(s)
- Jun Ma
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
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Bime C, Wei CY, Holbrook J, Smith LJ, Wise RA. Association of dietary soy genistein intake with lung function and asthma control: a post-hoc analysis of patients enrolled in a prospective multicentre clinical trial. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2013; 21:398-404. [PMID: 22885561 DOI: 10.4104/pcrj.2012.00073] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Broad dietary patterns have been linked to asthma but the relative contribution of specific nutrients is unclear. Soy genistein has important anti-inflammatory and other biological effects that might be beneficial in asthma. A positive association was previously reported between soy genistein intake and lung function but not with asthma exacerbations. AIMS To conduct a post-hoc analysis of patients with inadequately controlled asthma enrolled in a prospective multicentre clinical trial to replicate this association. METHODS A total of 300 study participants were included in the analysis. Dietary soy genistein intake was measured using the Block Soy Foods Screener. The level of soy genistein intake (little or no intake, moderate intake, or high intake) was compared with baseline lung function (pre-bronchodilator forced expiratory volume in 1 second (FEV(1))) and asthma control (proportion of participants with an episode of poor asthma control (EPAC) and annualised rates of EPACs over a 6-month follow-up period. RESULTS Participants with little or no genistein intake had a lower baseline FEV(1) than those with a moderate or high intake (2.26 L vs. 2.53 L and 2.47 L, respectively; p=0.01). EPACs were more common among those with no genistein intake than in those with a moderate or high intake (54% vs. 35% vs. 40%, respectively; p<0.001). These findings remained significant after adjustment for patient demographics and body mass index. CONCLUSIONS In patients with asthma, consumption of a diet with moderate to high amounts of soy genistein is associated with better lung function and better asthma control.
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Affiliation(s)
- Christian Bime
- Johns Hopkins University School of Medicine-Pulmonary and Critical Care Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland 21224-6801, USA.
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Berthon BS, Macdonald-Wicks LK, Gibson PG, Wood LG. Investigation of the association between dietary intake, disease severity and airway inflammation in asthma. Respirology 2013; 18:447-54. [DOI: 10.1111/resp.12015] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/30/2012] [Accepted: 09/27/2012] [Indexed: 01/05/2023]
Affiliation(s)
- Bronwyn S. Berthon
- Centre for Asthma and Respiratory Disease; Hunter Medical Research Institute; Newcastle; New South Wales; Australia
| | - Lesley K. Macdonald-Wicks
- Discipline of Nutrition and Dietetics; School of Health Sciences; University of Newcastle; Newcastle; New South Wales; Australia
| | - Peter G. Gibson
- Centre for Asthma and Respiratory Disease; Hunter Medical Research Institute; Newcastle; New South Wales; Australia
| | - Lisa G. Wood
- Centre for Asthma and Respiratory Disease; Hunter Medical Research Institute; Newcastle; New South Wales; Australia
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de Cássia Ribeiro Silva R, Assis AMO, Cruz AA, Fiaccone RL, Dinnocenzo S, Barreto ML, da Silva LA, Rodrigues LC, Alcantara-Neves NM. Dietary Patterns and Wheezing in the Midst of Nutritional Transition: A Study in Brazil. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2013; 26:18-24. [PMID: 23555072 PMCID: PMC3609612 DOI: 10.1089/ped.2012.0182] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 11/12/2012] [Indexed: 11/12/2022]
Abstract
To assess the influence of dietary patterns on the prevalence of wheezing in the child and adolescent population in Northeastern Brazil. This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeastern Brazil. The report of wheezing in the past 12 months was collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program phase III, adapted to Portuguese. Consumption patterns were derived from principal component analysis based on the frequency of consumption of 97 food items by the food frequency questionnaire. We also obtained the anthropometric status, level of physical activity, pubertal development, and socioeconomic information, for each participant. Multivariate logistic regression analyses were used to assess the associations of interest. Of the children surveyed, 10.6% reported having wheezing. We identified 2 dietary patterns named Western and Prudent. We found a positive statistically significant association of the Western pattern with wheeze (odds ratio=1.77, 95% confidence interval: 1.10-2.84) after adjustment for total energy intake and controlling for potential confounders. The results showed that the Western dietary pattern was associated with wheezing. Our result is according with previous findings reported in several other studies.
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Moreno-Macías H, Dockery DW, Schwartz J, Gold DR, Laird NM, Sienra-Monge JJ, Del Río-Navarro BE, Ramírez-Aguilar M, Barraza-Villarreal A, Li H, London SJ, Romieu I. Ozone exposure, vitamin C intake, and genetic susceptibility of asthmatic children in Mexico City: a cohort study. Respir Res 2013; 14:14. [PMID: 23379631 PMCID: PMC3579760 DOI: 10.1186/1465-9921-14-14] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 01/24/2013] [Indexed: 01/13/2023] Open
Abstract
Background We previously reported that asthmatic children with GSTM1 null genotype may be more susceptible to the acute effect of ozone on the small airways and might benefit from antioxidant supplementation. This study aims to assess the acute effect of ozone on lung function (FEF25-75) in asthmatic children according to dietary intake of vitamin C and the number of putative risk alleles in three antioxidant genes: GSTM1, GSTP1 (rs1695), and NQO1 (rs1800566). Methods 257 asthmatic children from two cohort studies conducted in Mexico City were included. Stratified linear mixed models with random intercepts and random slopes on ozone were used. Potential confounding by ethnicity was assessed. Analyses were conducted under single gene and genotype score approaches. Results The change in FEF25-75 per interquartile range (60 ppb) of ozone in persistent asthmatic children with low vitamin C intake and GSTM1 null was −91.2 ml/s (p = 0.06). Persistent asthmatic children with 4 to 6 risk alleles and low vitamin C intake showed an average decrement in FEF25-75 of 97.2 ml/s per 60 ppb of ozone (p = 0.03). In contrast in children with 1 to 3 risk alleles, acute effects of ozone on FEF25-75 did not differ by vitamin C intake. Conclusions Our results provide further evidence that asthmatic children predicted to have compromised antioxidant defense by virtue of genetic susceptibility combined with deficient antioxidant intake may be at increased risk of adverse effects of ozone on pulmonary function.
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Affiliation(s)
- Hortensia Moreno-Macías
- Universidad Autónoma Metropolitana, Unidad Iztapalapa, Avenida San Rafael Atlixco 186, edificio H-001, Col. Vicentina, 09430, D F, México City, Mexico.
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Haahtela T, Holgate S, Pawankar R, Akdis CA, Benjaponpitak S, Caraballo L, Demain J, Portnoy J, von Hertzen L. The biodiversity hypothesis and allergic disease: world allergy organization position statement. World Allergy Organ J 2013; 6:3. [PMID: 23663440 PMCID: PMC3646540 DOI: 10.1186/1939-4551-6-3] [Citation(s) in RCA: 207] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 12/21/2022] Open
Abstract
Biodiversity loss and climate change secondary to human activities are now being associated with various adverse health effects. However, less attention is being paid to the effects of biodiversity loss on environmental and commensal (indigenous) microbiotas. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases (IBD), type1 diabetes, and obesity. Altered indigenous microbiota and the general microbial deprivation characterizing the lifestyle of urban people in affluent countries appear to be risk factors for immune dysregulation and impaired tolerance. The risk is further enhanced by physical inactivity and a western diet poor in fresh fruit and vegetables, which may act in synergy with dysbiosis of the gut flora. Studies of immigrants moving from non-affluent to affluent regions indicate that tolerance mechanisms can rapidly become impaired in microbe-poor environments. The data on microbial deprivation and immune dysfunction as they relate to biodiversity loss are evaluated in this Statement of World Allergy Organization (WAO). We propose that biodiversity, the variability among living organisms from all sources are closely related, at both the macro- and micro-levels. Loss of the macrodiversity is associated with shrinking of the microdiversity, which is associated with alterations of the indigenous microbiota. Data on behavioural means to induce tolerance are outlined and a proposal made for a Global Allergy Plan to prevent and reduce the global allergy burden for affected individuals and the societies in which they live.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, PO Box 160, 00029, Helsinki, HUCH, Finland
| | - Stephen Holgate
- School of Medicine, University of Southampton, Southampton, UK
| | | | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Suwat Benjaponpitak
- Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Jeffrey Demain
- Allergy, Asthma & Immunology Center of Alaska, Dept of Pediatrics, University of Washington, Washington, USA
| | - Jay Portnoy
- University of Missouri-Kansas City School of Medicine, Missouri, USA
| | - Leena von Hertzen
- Skin and Allergy Hospital, Helsinki University Hospital, PO Box 160, 00029, Helsinki, HUCH, Finland
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Kamer B, Wąsowicz W, Pyziak K, Kamer-Bartosińska A, Gromadzińska J, Pasowska R. Role of selenium and zinc in the pathogenesis of food allergy in infants and young children. Arch Med Sci 2012; 8:1083-8. [PMID: 23319985 PMCID: PMC3542500 DOI: 10.5114/aoms.2012.32420] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 03/11/2011] [Accepted: 04/21/2011] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Selenium and zinc are indispensable microelements for normal functioning and development of the human body. They are cofactors of many enzymes of the antioxidative barrier (selenium - glutathione peroxidase; zinc - superoxide dismutase). The aim of the study was to evaluate the importance of selenium and zinc in the pathogenesis of food allergy in small children. MATERIAL AND METHODS The study was performed in 134 children with food allergy, aged 1 to 36 months. The control group was composed of 36 children at the same age, without clinical symptoms of food intolerance. Each child had estimated serum levels of zinc and selenium. Furthermore, the authors evaluated activity of glutathione peroxidase (GSH-Px) in erythrocyte lysates and serum. Tests were performed twice, before and after 6-month administration of elimination diet. RESULTS The obtained results showed that children with food allergy had significantly lower concentrations of selenium, zinc and examined enzymes in comparison to children from the control group. Concentration of selenium and zinc as well as activity of examined enzymes increased after application of eliminative diet. CONCLUSIONS In children with allergy decreased concentrations of selenium and zinc, and lower values of glutathione peroxidase and superoxide dismutase which increased after elimination diet were affirmed. These observations suggest their role in pathogenesis of food allergy. Conducted observations indicate the need to monitor trace elements content in the diet in children with food allergy. The results showed that children with food allergy had a weakened antioxidative barrier.
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Affiliation(s)
- Barbara Kamer
- 2 Department of Paediatrics and Allergology, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
| | - Wojciech Wąsowicz
- Department of Toxicology and Carcinogenesis, Institute of Occupational Medicine, Lodz, Poland
| | - Konrad Pyziak
- 2 Department of Paediatrics and Allergology, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
| | - Anna Kamer-Bartosińska
- Department of Operative Gynecology, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
| | - Jolanta Gromadzińska
- Department of Toxicology and Carcinogenesis, Institute of Occupational Medicine, Lodz, Poland
| | - Renata Pasowska
- 2 Department of Paediatrics and Allergology, Polish Mother's Memorial Hospital – Research Institute, Lodz, Poland
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Abstract
Asthma, one of the most prevalent diseases affecting people worldwide, is a chronic respiratory disease characterized by heightened airway inflammation, airway hyperresponsiveness and airflow obstruction in response to specific triggers. While the specific mechanisms responsible for asthma are not well understood, changing environmental factors associated with urban lifestyles may underlie the increased prevalence of the disorder. Vitamin D is of particular interest in asthma since vitamin D concentrations decrease with increased time spent indoors, decreased exposure to sunlight, less exercise, obesity, and inadequate calcium intake. Additionally, a growing body of literature suggests that there is a relationship between vitamin D status and respiratory symptoms, presumably through immunomodulatory effects of vitamin D. This review discusses vitamin D as it relates to asthma across the age spectrum, with a focus on human studies.
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